The activity level of people tends to decrease after a spinal cord injury. Studies have reported that daily wheelchair propulsion activity level of an individual with a spinal cord injury (SCI) is not sufficient to maintain or improve their cardiovascular fitness level. Sedentary individuals with paraplegia and tetraplegia have low maximal oxygen consumption. Research has shown that sedentary individuals with SCI are less fit than either their physically active counterparts or the sedentary unimpaired population and other research reports maximum oxygen uptake for people with paraplegia is lower than ambulatory subjects. Research shows that with a sedentary lifestyle and lower rate of maximum oxygen consumption, cardiovascular diseases are an increasing health concern for wheelchair users and the SCI population. We have been studying exercise systems for people with lower extremity impairments. Our previous efforts have resulted in training rollers, the GAMEwheel system, and the SMARTwheel. This proposal builds upon this previous work and experience. We have shown that the GAMEwheel can help people to exercise and possibly reduce the risk of developing cardiovascular disease. However, research with the SMARTwheel shows that the GAMEwheel systems tends to cause people to shorten their stroke and increase their stroke frequency which have been shown to be related to joint degeneration. We propose a simpler and more universal concept based upon a modified arm-ergometer, named the GAMEcycle. The will be based upon an arm-ergometer placed on a turnstile to allow steering in much the same way as an arm-cycle. Sensors on the sprocket of the arm ergometer will be used to record the speed, and sensors on the turnstile will be used to record the direction. The speed and direction signals will be used through the game port of personal computer to control commercially available computer games. PROPOSED COMMERCIAL APPLICATION: NOT AVAILABLE